Is there any progress in routine management of lung cancer patients? A comparative analysis of an institution in 1996 and 2006.
Is there any progress in routine management of lung cancer patients? A comparative analysis of an institution in 1996 and 2006.
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DOI：
10.2478/v10019-009-0008-x
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发表时间：
2009-01-01
影响因子：
2.4
通讯作者：
Sok, Miha
中科院分区：
文献类型：
--
作者：
Debevec, Lucka;Jeric, Tina;Sok, Miha
背景资料。这项研究的目的是通过比较1996年诊断的345名患者(2002年进行的分析)和2006年诊断的405名患者(2008年进行的分析)的结果，确定斯洛文尼亚戈尔尼克大学呼吸系统和过敏性疾病大学诊所十年来肺癌患者常规管理的最终进展。两组患者的年龄和I、II期患者数量相近，但2006年的患者中女性相对较多，表现状态更好，临床分期和肿瘤组织学更准确。用于评估治疗进展的参数如下：从入院到诊断和手术的时间；分期的精确度；切除患者的临床和病理分期的一致性；剖胸探查的百分比；以及新治疗方式的使用。选择/实际采用初级治疗方式的患者比例和存活率也可用于评估进展情况。虽然从入院到镜检确诊的时间从2006年的平均7.4天增加到2006年的8.6天并不是必要的，但进展是由以下因素确立的：更准确的临床分期(I和II期以及A和B期，小细胞肺癌患者的TNM分期也包括在内)；手术切除患者的临床和病理分期更加符合(46%对58%)；开胸探查百分比(13%对4%)；更多地将多模式治疗作为主要治疗方式(放/化疗、新辅助化疗)；新进行了射频肿瘤消融术。选择/实际手术的比例从76%增加到93%，所有患者的中位生存期从6.2个月增加到10.6个月。一年生存率从33.6%上升到45.8%，两年生存率从17.4%上升到23%。更好的分期、更低的探查开胸比例、新的治疗方式的使用、选择的治疗与实际治疗之间的微小差异以及短期生存率的提高，证明了常规肺癌治疗的进步。
Background. The aim of the study was to establish eventual progress in routine management of lung cancer patients over a ten-year period at University Clinic for Respiratory and Allergic Diseases Golnik, Slovenia, comparing the results of analysis of 345 patients, diagnosed in 1996 (with analysis performed in 2002), and 405 patients, diagnosed in 2006 (with analysis performed in 2008).Patients and methods. The patients of both analysed groups were of comparable age and number of patients in stage I and II, but there were relatively more females, patients with better performance status, more precise clinical staging and tumour histology in the 2006 group. The parameters used for assessing the progress of management were as follows: time period from admittance to diagnosis and to surgery; precision of staging; accordance of clinical and pathological staging in resected patients; percentage of exploratory thoracotomy; and use of new treatment modalities. The proportion of patients in selected/actual primary treatment modality and survival rate could also be used for assessing the progress.Results. Although unessential longer time from admittance to microscopic confirmed diagnosis increased from a mean 7.4 to 8.6 days in 2006 progress was established by the following: more precise clinical staging ( stage I and II also A and B stage, TNM staging also in small-cell lung cancer patients); improved accordance with clinical and pathological staging in resected patients (46% against 58%); decreased percentage of exploratory thoracotomy (13% against 4%); increased use of multimodality therapy as primary treatment modality (radiotherapy/chemotherapy, neoadjuvant chemotherapy); newly performed radio frequency tumour ablation. The proportion in selected/actual surgery increased from 76% to 93% and median survival rate of all patients from 6.2 to 10.6 months. One-year survival increased from 33.6% to 45.8% and two-year survival from 17.4% to 23%.Conclusions. Progress in routine lung cancer management was proved by better staging, lower percentage of exploratory thoracotomy, use of new treatment modalities, minor discordance between selected and actual therapy, and improved short-term survival rate.